HomeMy WebLinkAboutPermit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
9 r.1S1's�L1L5
- r
V E 0 E E D, � � "" Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial x Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 8503 Paso Robles Blvd., Fort Pierce, FL 34951
Property Tax ID #: 1301-610-0021-000-3
Site Plan Name:
Project Name: Stephanie Gordon
DETAILED DESCRIPTION OF WORK.:
Sir Ll 7 ,m(�C& Uxn&VA
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical
Electric
_ Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ ?INO15—
Gas Piping
_ Sprinklers
Lot No. 6
Block No. 2
_ Shutters _ Windows/Doors _ Pond
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Stephanie Gordon
Address: 8503 Paso Robles Blvd.
Name: Scott Berman
Company: Florida Window & Door
City: Fort Pierce State: _
Zip Code: 34951 Fax:
Phone No. 772-321-5441
Address: 1125 N Dixie Highway
City: Lake Worth State: FL
Zip Code: 33460 Fax:
Phone No 561-340-4300
E-Mail: sgordonhi@yahoo.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail howard@floridawindowanddoor.com
State or County License 28576
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State,
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
in
which is conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
r"
Signature o caner essee/Contractor as Agent for Owne
Signature of Contractor License Holder
STATE OF FLORID
STATE OF FLORIDA
COUNTY OF_ VaC,�Q
COUNTY OF Palm Beach '4b
P
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
y rhysical Presence or Online Notarization
x Physical Presence or Online Notarization
this day of i+lnet 2020 by
this day of cp 2020 by �0,, o
aoo"'
Q 3 D
Stephanie Gordon
Scott Berman �y 3 c
Name of person making statement.
Name of person making statement. 0
to
Personally Known OR Produced Identification
Personally Known X OR Produced Identificati 5�
Type of Identification
Type of Identification
Produced
Produced a
t Mk*"
( �1 AlAl—
Ilc ko .
(Signatur'e of Notary Public- State of Florid State of
nature of Notary Publtc- State of Florida )
2
C.ornffo H
Commission No. m o) (Se, * Exores7
2%72
ission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVI-EW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20